Organization
GREGORY M. GRAHAM, DMD,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY M. GRAHAM DMD (DOCTOR/OWNER)
(478) 452-0270
Entity
Organization
Contact information
Practice address
385 MEADOW RIDGE DRIVE, GREGORY M GRAHAM, DMD, LLC, MILLEDGEVILLE, GA 31061-8741
(478) 452-0270
(478) 454-1068
Mailing address
385 MEADOW RIDGE DR, GREGORY M GRAHAM, DMD, LLC, MILLEDGEVILLE, GA 31061-8741
(478) 452-0270
(478) 454-1068
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN010029
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00289341B
—
GA
Enumeration date
03/31/2008
Last updated
07/15/2008
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